Sexual Positioning Practices and Sexual Risk Among Black Gay and Bisexual Men: A Life Course Perspective
- 211 Downloads
Increased attention has highlighted the role of age and sexual development on HIV risk among Black MSM (BMSM); limited focus has been given to the relationship of sexual positioning to HIV risk along the life course. This study examined BMSM’s life course sexual positioning practices and accompanying HIV/STI risks. Twenty-six Black gay and bisexual men ages 24–61 completed life history interviews in Los Angeles, California, between September and November 2015. Thematic analysis evaluated domains including major life events, substance use, social support, and partner selection. Varying exposure to HIV treatment and prevention options and venues to meet male partners revealed generational differences in sexual risks. Childhood sexual abuse and internalized homonegativity impacted personal development, sexual positioning, and condom negotiation. BMSM also assumed sexual positioning using masculinity stereotypes and body language. Clarifying the sexual development and HIV/STI risk contexts among BMSM could better inform current treatment and prevention needs.
KeywordsSexual positioning Black MSM HIV risk STI risk Culture
We acknowledge and thank Greg Wilson and the staff at REACH LA for all their support as the research site for this study.
Complains with Ethical Standards
Conflicts of interest
The authors declare no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Centers for Disease Control and Prevention. Lifetime risk of HIV diagnosis in the United States [Internet]. 2016 [cited 2016 Feb 28]. http://www.cdc.gov/nchhstp/newsroom/docs/factsheets/lifetime-risk-hiv-dx-us.pdf.
- 6.Mayer KH, Wang L, Koblin B, Mannheimer S, Magnus M, del Rio C, et al. Concomitant socioeconomic, behavioral, and biological factors associated with the disproportionate HIV infection burden among black men who have sex with men in 6 U.S. Cities. PLoS ONE. 2014;9(1):e87298.CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Centers for Disease Control and Prevention. CDC—HIV/AIDS—Gay and bisexual men’s Health [Internet]. 2014 [cited 2014 Dec 3]. http://www.cdc.gov/msmhealth/HIV.htm.
- 18.Nelson KM, Gamarel KE, Pantalone DW, Carey MP, Simoni JM. Sexual debut and HIV-related sexual risk-taking by birth cohort among men who have sex with men in the United States. AIDS Behav. 2016;10:1–10.Google Scholar
- 19.Glick SN, Cleary SD, Golden MR. Increasing acceptance of homosexuality in the United States across racial and ethnic subgroups. J Acquir Immune Defic Syndr [Internet]. 2015 Jun 26 [cited 2016 Dec 5]. https://iths.pure.elsevier.com/en/publications/increasing-acceptance-of-homosexuality-in-the-united-states-acros.
- 29.Schechter MT, Boyko WJ, Douglas B, Willoughby B, McLeod A, Maynard M, et al. The vancouver lymphadenopathy-AIDS study: 6. HIV seroconversion in a cohort of homosexual men. CMAJ Can Med Assoc J Assoc Medicale Can. 1986;135(12):1355–60.Google Scholar
- 32.Wolitski RJ, Branson BM. “Gray area behaviors” and partner selection strategies. In: O’Leary A, editor. Beyond Condoms [Internet]. Springer US; 2002 [cited 2015 Apr 21]. pp. 173–98. http://link.springer.com/chapter/10.1007/0-306-47518-9_8.
- 33.Dangerfield D II, Smith LR, Williams J, Unger J, Bluthenthal R. Sexual positioning among men who have sex with men: a narrative review. Arch Sex Behav. 2016;13:1–16.Google Scholar
- 38.Dworkin SL, Zakaras JM, Campbell C, Wilson P, Grisham K, Chakravarty D, et al. Relationship power among same-sex male couples in New York and San Francisco: laying the groundwork for sexual risk reduction interventions focused on interpersonal power. J Sex Res. 2017;4:1–13.Google Scholar
- 55.Mimiaga MJ, Reisner SL, Bland S, Cranston K, Isenberg D, Driscoll MA, et al. “It’s a quick way to get what you want”: a formative exploration of HIV risk among urban Massachusetts men who have sex with men who attend ex parties. AIDS Patient Care STDs. 2010;24(10):659–74.CrossRefPubMedGoogle Scholar
- 56.Denzin NK, Lincoln YS. The SAGE Handbook of Qualitative Research. SAGE; 2011. 785 p.Google Scholar
- 57.Ober AJ, Dangerfield II DT, Shoptaw S, Ryan G, Stucky B, Friedman SR. Using a “positive deviance” framework to discover adaptive risk reduction behaviors among high-risk HIV-negative Black men who have sex with men. AIDS Behav. 2017;1–14.Google Scholar
- 63.Adam BD, Hart TA, Mohr J, Coleman T, Vernon J. HIV-related syndemic pathways and risk subjectivities among gay and bisexual men: a qualitative investigation. Cult Health Sex. 2017;4:1–14.Google Scholar
- 66.Cahill S, Taylor SW, Elsesser SA, Mena L, Hickson D, Mayer KH. Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts. AIDS Care. 2017;4:1–8.Google Scholar
- 69.Patton ME, Kidd S, Llata E, Stenger M, Braxton J, Asbel L, et al. Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men—STD Surveillance Network, United States, 2010–2012. Clin Infect Dis. 2014 Mar 18;ciu184.Google Scholar
- 73.Hales RE. The aAmerican psychiatric publishing textbook of psychiatry. Washington: American Psychiatric Pub; 2008. 1820 p.Google Scholar